Physical performance during rehabilitation in persons with spinal cord injuries

Purpose: The Objective of the present study was to evaluate the effect of rehabilitation on physical capacity, mechanical efficiency of manual wheelchair propulsion, and performance of standardized activities of daily living (ADL). Methods: Nineteen recently injured subjects with spinal cord injuries were tested on a wheelchair ergometer (maximal isometric strength, sprint and maximal power output, and peak oxygen uptake) and during standardized ADL (physical strain and performance time) at the beginning (t1) and at the end (t2) of the active rehabilitation period. Results: Paired Student t-tests showed significant increases for maximal isometric strength (24%, P < 0.01), sprint power output (17%, P < 0.001) and maximal power output (38%, P < 0.001). Peak oxygen uptake showed no statistically significant improvement (11%, P = 0.06). Mechanical efficiency of submaximal wheelchair exercise was significantly higher at t2 (9.0%) compared to t1 (7.9%, P < 0.01). No significant differences were found for physical strain during ADL, except for passing a door (P < 0.05). Performance time showed a significant decrease for most tasks. Conclusions: The results of this study show considerable improvements in physical capacity and mechanical efficiency of manual wheelchair propulsion during rehabilitation, and a concomitant lower performance time during standardized ADL. The higher mechanical efficiency and the decrease in performance time during standardized ADL suggest improvement in wheelchair propulsion technique.